Individual
JANICE JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L,CHT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-612
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808172000
—
ID
Enumeration date
05/04/2007
Last updated
01/07/2015
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